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HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS

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5 CELEBRITY DIETS TO AVOID

In January the British Dietetic Association (BDA) announced its annual list of celebrity diets to avoid. Here, according to the BDA, are the top 5 celeb diets to avoid in 2017:

1. Clean eating Celebrity Link: Miranda Kerr and Jessica Alba are allegedly fans of this diet.

• What’s it all about? The idea is to avoid all processed foods by eliminating refined sugar, cooking from scratch, and choosing foods in their natural state. But some extreme versions exclude gluten, grains, dairy, and even in some cases encourage a rawfood diet.

BDA Verdict: While it is Please see TOP 5 page 2

MARCH 3, 2017

Get going. Get happy.

As you have probably noticed, people who exercise a lot tend to be almost missionary in their zeal for exercise. They talk about their “runner’s high,” and say the only thing harder than starting to exercise would be to quit.

Sometimes you might almost think they’re addicted to exercising.

And sometimes you might almost be right.

As most committed exercisers will tell you (at the drop of a hat), when those endorphins kick in, it’s a natural high.

That natural high is more than a figure of speech.

Endorphin is a combination of two words: “endogenous,” meaning something that has an internal origin or cause, and “morphine,” which probably needs no defi nition.

The word has been around for less than 50 years. It was 1973 when scientists discovered that neurons in several regions of the brain had receptors for opiates. Realizing this probably wasn’t just a convenience for opium addicts, scientists concluded the brain must manufacture chemicals very similar to opium. And very soon the first of some 20 natural opiates produced in the brain were discovered (“opioid peptides,” technically speaking), all collectively known as endorphins.

While the full role of opioid peptides is still a subject of study, the working theory is that they are released by the brain in times of stress to minimize pain. On the other hand, laughter and physical exercise also stimulate endorphin production. In other words, endorphins are natural feel-good chemicals. They make bad times good and good times better. They don’t This is your brain on morphine. And a bicycle. require a prescription; they aren’t expensive or illegal; no one ever overdoses on them.

Yes, anyone who thinks the fabled “runner’s the most under-utilized antidepressant there is. More high” is imaginary is sadly mistaken. Endorphins are than that, endorphins can even produce feelings of certainly real, and they are the chemical kissing cousins of euphoria that rival illicit drugs. morphine, a drug justly famous for its pain-relieving, moodSome people don’t exercise because of their aches and pains; enhancing properties. others exercise because of their aches and pains, as a source of Endorphins explain why people who exercise have fewer aches “natural morphine” and its pain-relieving abilities. Along the and pains and why exercising makes people feel better all over, way, they also improve their cardiovascular and respiratory including mentally. We sometimes think exercise is building health, strength and muscle tone, weight, BMI, overall fitness, and benefiting certain muscle groups in our arms, abdomen, self-esteem, and their general mood and outlook on life. legs, and so forth — and it is — but exercise, as our illustration Not a bad return on an investment that is so fun and pleasant: suggests, also beneficially affects Muscle No. 1, the brain. walking, running, dancing, riding a bike, throwing a frisbee Little wonder that for some people, exercise is the best and around, playing basketball, or any one of a thousand other ways most effective antidepressant. In fact, exercise has been called to get moving. +

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beneficial to reduce refined sugar and limit processed food intake, the idea of foods being “clean� and “dirty� is concerning. In some circumstances this can be a prelude to “Orthorexia Nervosa� — an obsession with foods the individual personally considers to be healthy while eliminating any food deemed by them to be unhealthy. In many cases, foods that are actually nutritionally beneficial, such as those containing whole grains, fruit and dairy, are deemed as unhealthy with no basis in scientific evidence. Unless you have a medically diagnosed intolerance or allergy to certain foods, there is no need to eliminate them, and doing so could lead to deficiencies in your diet.

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AUGUSTA MEDiCAL EXAMINER

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2. Diet pills Celebrity Link: Kim Kardashian has reportedly used diet pills to lose weight. • What’s it all about? Many of these pills claim to keep fat from being absorbed by your body, or “meltâ€? fat, while others claim to suppress appetite or boost metabolism.

BDA Verdict: Danger! Diet pills should never be taken without first consulting your doctor, pharmacist, or dietitian, as even regulated weight loss medicines on prescription can have nasty side effects, including diarrhea.

Diet pills sold online are often unregulated and can contain substances not licensed for human consumption, like pesticides, and have proven to be fatal.

3. Teatoxes Celebrity Link: Nicki Minaj and Kylie Jenner’s Instagram accounts feature these products, and Britney Spears reportedly uses them. • What’s it all about?

Teatoxing is short for “tea

detoxing.� These tea products have varying claims from detoxing the body, improving skin, reducing bloating, and losing weight.

BDA Verdict: These teas often contain extra caffeine in the form of guarana or yerba mate, diuretic ingredients such as dandelion and nettle, and the laxative senna, which is not safe to take for longer than a week without medical supervision.

They might create the impression of weight loss and detoxification, but this is usually water-weight loss. Any further weight loss would most likely be due to substituting these teas in the place of high calorie drinks or food or as part of fasting plan. There’s also a risk of side effects such a diarrhea, dehydration, and electrolyte imbalance.

4. The 6:1 diet Celebrity Link: Coldplay singer Chris Martin reportedly followed this “diet,â€? claiming that it made him more creative and improved his voice. • What’s it all about? The 6:1 diet involves eating like you usually do for six days and then for one day a week, some followers of this diet completely fast, meaning they don’t consume any food for 24 hours.

BDA Verdict: Complete fasting, unless properly managed, is likely to lead to a lack of concentration, fatigue, and low mood, which isn’t going to make you more productive. There is no evidence that a diet like this would make you more creative either, and depending on your age, health and lifestyle, fasting could be dangerous. If you want to go down the fasting route, it is important to choose an evidence-based plan and consult a medical professional to ensure that it is done in a healthy and safe way.

5. Green juices Celebrity Link: Blake Lively and Gwyneth Paltrow reportedly consume “green juices.â€? • What’s it all about? Another means of “detoxingâ€? and weight management, green juices are essentially juices or smoothies made up of various fruits, vegetables, powders etc. Fans claim benefits ranging from detoxing to rejuvenation and weight loss.

BDA Verdict: The body is perfectly capable of detoxing itself without the aid of these green liquid concoctions. Adding a green juice to an unhealthy diet is never going to make up for poor choices when it comes to food. In addition, people add in ingredients like nuts, coconut oil, and whole avocados to their green breakfast juices too — meaning these juices can add up to as much as 400 calories per glass. If you are still eating your normal breakfast on top of this, you are more likely to gain than lose weight. A green juice is not a magic fi x. Keep your veggies and fruit whole and limit juices and smoothies to 150 milliliters per day.

Sian Porter, consultant dietitian and spokesperson for the BDA, says if something sounds too good to be true, it probably is. “Make small sustainable changes you need to make forever,� he said. “An eating pattern for life should be the one you can stick to in the long term, not a quick fi x.

Enjoy a rich variety of foods in appropriate portion sizes — moderation is key as well as being physically active. Losing weight is challenging and keeping it off is too, but it’s not impossible. Don’t make it even harder for yourself by following a fad diet.� + — Source: The British Dietetic Association

MARCH 3, 2017

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AUGUSTA MEDiCAL EXAMINER

The

Advice Doctor ©

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Everything you need.

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Services offered in the Augusta area: • • • • • • • •

Short-Term Rehabilitation • Physical Therapy Long-Term Care • Occupational Therapy Inpatient Rehabilitation • Speech Therapy IV Therapy • Private, Semi-Private Wound Care Rooms Pain Management • Trach Care Provided 24 Hour Nursing Services • VA Contract Facility Oxygen Therapy pruitthealth.com

— Timid Investor Dear Tim, The topic you bring up is probably shared by millions of people, but here’s the thing: other than feeling hungry or full, there really shouldn’t normally be a lot of “gut feelings” going on, and if they are, they should be temporary, not chronic.

Unfortunately, many people frequently experience stomach cramps, bloating, gas, heartburn, digestive rumbling and grumbling sounds, diarrhea, constipation and nausea.

Perhaps the fi rst and easiest option for people in these situations is a food diary. Keep track of what you eat and note in writing any symptoms of abdominal discomfort you experience.

In short order you may identify a connection between a certain food or food group and the onset of symptoms. If you avoid the culprit, your symptoms may disappear.

If that doesn’t work and you seek a doctor’s help, you will be a step ahead of the game when you can provide the doctor with what you have discovered (or not discovered) via your diary.

Not every gastric issue is diet-related, of course. There are medical disorders like Crohn’s disease, ulcerative colitis, the twins diverticulitis and diverticulosis, irritable bowel syndrome, colon cancer, and still others. Some are merely annoyances, others can become life-threatening, so it’s very important to listen to your body. Don’t ignore symptoms! See a doctor, get help and get relief — both digestively and mentally! + Do you have a question for The Advice Doctor about life, love, personal relationships, career, raising children, or any other important topic? Send it to News@AugustaRx.com. Replies will be provided only in Examiner issues.

AUGUSTA

One family of providers.

Dear Advice Doctor, I work with a guy who is always trying to cook up some new business on the side. I guess he’s a frustrated entrepreneur who is stuck working for someone else - but not for lack of trying. He has recently come up with yet another “sure-fire” idea that he has invited me to invest in. I’m tempted. It could be a big payoff. On the other hand, I have a gut feeling that this will be just another of his ideas that crashes and burns. Any suggestions?

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MEDICAL EXAMINER

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AUGUSTA’S MOST SALUBRIOUS NEWSPAPER

www.AugustaRx.com The Medical Examiner’s mission: to provide information on topics of health and wellness of interest to general readers, to offer information to assist readers in wisely choosing their healthcare providers, and to serve as a central source of news within every part of the Augusta medical community.

Submit editorial content to graphicadv@knology.net Direct editorial and advertising inquiries to: Daniel R. Pearson, Publisher & Editor E-mail: Dan@AugustaRx.com AUGUSTA MEDiCAL EXAMINER P.O. Box 397, Augusta, GA 30903-0397

(706) 860-5455 www.AugustaRx.com • E-mail: graphicadv@knology.net Opinions expressed by the writers herein are their own and/or their respective institutions. Neither the Augusta Medical Examiner, Pearson Graphic 365 Inc., or its agents or employees take any responsibility for the accuracy of submitted information, which is presented for general informational purposes only. For specific medical advice, diagnosis and treatment, consult your doctor.

The appearance of advertisements in this publication does not constitute an endorsement of the products or services advertised. © 2017 PEARSON GRAPHIC 365 INC.

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MARCH 3, 2017

AUGUSTA MEDiCAL EXAMINER

#39 IN A SERIES

OLD NEWS

Who is this?

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POINTS OF INTEREST TO FORMER KIDS

by Trisha Whisenhunt, Senior Citizens Council

P

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orn in 1809, this noted gentleman, sporting a name every reader of this newspaper knows, had a somewhat checkered medical career. Good thing plenty of people don’t even know he had a medical career in the first place.

Among his friends and acquaintances were the great and still-famous authors Alfred Lord Tennyson, Henry James, Walt Whitman, James Russell Lowell, Washington Irving, John Greenleaf Whittier, Henry Wadsworth Longfellow and Ralph Waldo Emerson. He was no slouch at writing himself; with friends like that how could you not be? Abraham Lincoln often quoted his poem, “The Last Leaf,” and Edgar Allen Poe called the poem one of the finest works in the English language. His 1858 book, The Autocrat of the Breakfast Table, sold 10,000 copies in its first three days of release. He wrote the famous poem “Old Ironsides.”

He also invented something we have probably all used, the stereoscope (see left), a device for viewing pictures that gives them 3-dimensional qualities.

Somehow he also found the time to attend law school — briefly — before switching to and graduating from medical school. Harvard Medical School, in fact.

As a physician, Dr. Oliver Wendell Holmes, Sr. had a medical career that was curiously up and down. Thanks to the beneficial influence of a hometown medical mentor and a pathologist he worked under during training in Paris, Holmes was often far ahead of his time, both medically and socially.

For example, he won Harvard’s prestigious Boylston Prize for an essay extoling the benefits of a new and to many physicians unfamiliar item of technology, the stethoscope. He denounced various common practices of the day as quackery, from bloodletting to homeopathy, even publishing an essay “Homeopathy and Its Kindred Delusions.” Before germ theory was a scientifically established fact, Holmes pointed the finger at doctors going from patient to patient without handwashing as a major contributor to puerperal fever, a then-common and often fatal infection among new mothers. This earned him the scorn of many in the medical establishment. Dr. Charles D. Meigs, for instance, responded that ‘doctors are gentlemen, and a gentlemen’s hands are always clean.’

Socially, Oliver Wendell Holmes, Sr. was also a maverick, but one without much of a backbone. Shortly after being appointed dean of Harvard Medical School in 1853 (a position he held until 1882), Holmes took under considered an application for admission from a woman. The action was met with a storm of protest from students, faculty and administration, and Holmes quickly asked her to withdraw her application. (Harvard Medical School would not admit its first female student until 1945.) The same year, Holmes admitted Martin Delany and two other black men to the school, igniting another firestorm. In response, Holmes told the three men they would have to leave the school after that semester.

Holmes’ son, jurist Oliver Wendell Holmes, Jr., served in the Union Army during the Civil War and was wounded in action three times before later (1902-1932) serving on the Supreme Court of the United States. +

HEALTH AND SAFETY

rotesters demonstrating with hate and violence their desire for a hate and violence-free nation is beyond ridiculous. Let’s put politics aside and focus on the health and safety issues they have created for the rest of us.

It is against the law to put your hands on any person for any reason. A difference of opinion is at the very bottom of the list of excuses for doing so. Experience tells us if a child is not reprimanded for a transgression, they get the message that their behavior is acceptable and they continue without correction. As long as our precious little Snowflakes suffer no consequences for physically threatening and harming people, physically blocking entrance into public buildings and destroying private and public property, they will continue to do it.

This has to stop before someone is crippled or killed. Our law enforcement officers have to be able to perform their jobs to keep the rest of us safe.

Protester’s typical modus operandi of

blocking highways and roads must stop. It’s not about the rest of us being prevented from getting to work on time; this tactic is dangerous for protesters. I have seen YouTube videos of cars plowing through their handholding lines.

I am also concerned about what will happen when an ambulance attempts to get through with a seriously ill or injured citizen in tow and can’t reach the hospital because protesters are blocking traffic. A preventable death would be unforgivable and a lawsuit is sure to follow.

My question: against whom? It will be a tough call to hold the protestors responsible since they have

begun covering their faces (one only hides when they know they are wrong, and this says much about their non-point). Sue the city for not breaking up the protest/ riot? A caravan of tow trucks should pull up and cart blocking vehicles away.

People are getting tired of the adolescent fit-throwing and are taking matters into their own hands. Example: the UPS driver who saw a group burning the American flag. He got out of his truck with a fi re extinguisher and took the flag away from them. The group wanted him fi red; UPS backed him. There is also an increase in private citizens aiding police officers they see struggling with noncompliant suspects.

While these pockets of protest are the minority, it doesn’t seem that way because the media loves to run it front and center.

It’s troubling how adamant these young people are about issues they don’t educate themselves on, relying instead on word of mouth and the biased media to inform them. I am looking for solutions from the people who can implement them. Stop this before someone is trampled, beaten to death, or fails to get medical help. I haven’t figured out if these individuals with so much free time on their hands are stupid, being paid or both.

Either way, yelling the loudest doesn’t make them right. +

MYTH OF THE MONTH Avoiding bacteria protects health and wellness True — if you remove that first word: “avoiding.” The truth is humans couldn’t live without bacteria, and are, in the words of Scientific American magazine, “practically walking petri dishes.”

SA says if census workers were dispatched to count all our bacterial and human cells, the bacterial cells would outnumber human cells by a margin of 10 to 1.

(Fortunately, bacterial cells are far smaller than human cells.)

Bacteria in our bodies was at one time believed to be uniformly harmful and to be avoided at all costs. More recently, scientists concluded our onboard bacteria was a lot like the inactive ingredients in medicines: it doesn’t do any harm, but it doesn’t really help us either. The

latest findings clearly show how vital bacteria is to human life and health. An estimated 500 species of bacteria have set up camp in our intestines alone, and we would have digestive troubles aplenty without them.

In laboratory studies, germ-free mice got limited nutrition from a normal healthy diet. Intestinal bacteria also helps keep our immune system healthy.

No one is suggesting we should abandon soap and water, but people who are germaphobes are fighting a losing (and unnecessary) battle. + — by F. E. Gilliard, MD, Family Medicine 4244 Washington Road, Evans, GA 30809 706-760-7607

MARCH 3, 2017

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AUGUSTA MEDiCAL EXAMINER

WHAT EVERYBODY OUGHT TO KNOW res?

ABOUT AN OUCH OF PREVENTION

k good eno r skin can ugh cer? son.”

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lifelong friend, Peggy Mercer, oscillates between adorable and hysterical, depending upon her mood and the situation of the moment. She is one of those women who has a natural born Drama Queen persona through no conscious efforts of her own. Everything she does creates a stir. Or a blip on the radar screen. Or a deflection on the Richter scale.

A black cat once died of fright because he crossed her path.

Peggy told me once her goal was to live a pain-free life.

She paid no attention when I explained being painless is physically impossible and it is not good. Pain is a necessary and desirable warning sign from Mother Nature telling you when something is wrong. If you have no pain at all, you will do irreparable damage to your body on a daily basis.

Peggy had an experience which led me to write this called this “Ouch of Prevention” tale. Peggy got a toothache. She knew not why.

She brushes her teeth several times a day. Uses mouth wash by the gallon. She has a corner on the world market for dental floss.

But a damned old cavity attacked her tooth, nonetheless.

She went to the local dentist. He dosed her with Valium for some “twilight sleep.” It didn’t work. He shot her up with deadening medicine.

Despite heroic efforts by the dentist and his assistants, the fillings failed ... twice.

Could the cause have been

that Peggy is not necessarily the best dental patient ever?

When dental assistances see her on the schedule, they develop migraine headaches in unison and fail to show up unless threatened with termination.

On one of her many trips for books and music, she woke up early one morning in Nashville, Tennessee with her jaw throbbing and pulsating like a malfunctioning neon sign. Pain shot through her head and made frying noises in her brain.

She would have called room service for a .38 to shoot herself, but she did not have time for the investigation and endless questioning that was sure to follow. Nor did she have time for the inquest should she actually be successful in killing herself.

But this pain had to go.

Instead, she managed to find an unsuspecting dentist with a young practice who would see her immediately.

Holding an ice pack to her jaw and makeup on only one side of her face, she flopped into his dental chair and frantically intoned, “my tooth is killing me. Fix it right now or lay the damn thing on a stump.”

“What?” the young dentist asked with eyes wide with astonishment.

He was a semi-Yankee from northern Kentucky. Had he been from South Georgia, he would have known “lay it on a stump” meant to pull the tooth immediately.

“Fix it or yank it out before I scratch your eyes out. Now get to it before I lose my patience.”

HE

T

t s e B The dentist tried his dead level best to be professional and proficient. He failed. “Old time dentists pulled teeth.

Modern dentists preserve teeth,” he said, clearly including himself among the latter.

Even so, the dentist went to work.

The tooth hurt in new ways. Peggy let out grunts and groans and sounds best reserved for Big Foot reality shows or Elvira horror shows.

She ripped off the dainty towel draped around her neck, sent semi-sterile instruments crashing off the ceiling, walls and floor before charging out through the waiting room.

Waiting patients panicked, thinking they were in a scene involving Jack Nicholson or maybe The Little Shop of Horrors.

Undoubtedly, the unsuspecting dentist and his practice were ruined for the day. Or maybe for the week.

Or even permanently.

Peggy return to South Georgia and semi-normal mental function, and regained most of her senses. She was thankful she was not sued or arrested for disrupting a medical enterprise, damage to property, creating a nuisance,

e n i c i d ME

or any other mean, nasty legal devices that might have come her way.

Later she wished she had taken care of minor dental problems before they became major dental problems, before the “ouch” coefficient touched off the Richter scale.

Academically, she has reconciled to reality and knows her fears of dentists and dental procedures are less than desirable. But she is not alone.

Why do people do things that delay their medical care?

Many reasons come to mind: • Blocking out they have a problem • Embarrassment • No money • Lack of insurance coverage • Difficulty in getting off work • Difficulty getting an appointment • Fear of examination • Fear of what the doctor might find

• Hoping the problem will go away on its own • Reluctance to admit a physical weakness All of us have had such thoughts. It is normal. But is it worth the additional problems you encounter by putting off preventive health care?

I don’t think so. But if you doubt me, just ask Peggy and walk a few miles in her shoes.

She did not have nearly as much fun getting her dental problems straightened out as I did writing her story and you did reading it.

Maybe one day she will forgive me for exposing her “Ouch Factor” and reminding her that an “Ouch of Prevention” is worth a ton of cure. And maybe she will start speaking to me again. +

Bad Billy Laveau is a formerlyretired MD who wields a pointed sense of humor - and now, tongue depressors too.

He speaks and entertains at events for audiences not subject to cardiac arrest secondary to overwhelming laughter and glee. BadBilly@knology.net or 706-306-9397.

F REE T AKE-HO ME CO PY!

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My mystery diagnosis — by Marilyn Botta, Augusta, Georgia

T

here never was a single thunderbolt moment, but very gradually my body was changing. Hindsight is a wonderful thing and we all have 20/20, but at the time, I couldn’t even fathom that something devastating was brewing.

I was an avid runner living in Augusta in 2011. Running my regular 6-10 mile route, I began to trip. At fi rst I attributed this to just being clumsy, which I never was before. It is amazing how the human mind can deny and deny something that is so obviously wrong.

Running, previously my most enjoyable past time, began to be fraught with anxiety about whether or not I would trip and fall. Each time I ventured out, I would lecture myself lifting my right foot up.

When I did trip, I would chide myself by saying, “What’s wrong with you—Pick up your foot, idiot!”

But no matter how much I tried, my right foot would not lift far enough off the ground, resulting in tripping. One day after a very frustrating and anxiety-ridden run, I checked the tread of my sneakers and saw that the toe of the right sneaker was almost completely worn down, while the left sneaker was fine. Yet I still thought I was merely clumsy.

A few days before Thanksgiving, I went to Kroger and took a huge fall in the parking lot, spilling my grocery bag. I quickly got up and tried to figure out what had happened. Apparently while getting to my car, my right foot did not clear the curb—more like dragged—and down I went. This pattern continued until August 2012.

As an obsessive runner I had multiple knee surgeries over the years for a torn meniscus. In August 2012, I underwent one more surgery on my damaged right knee.

I had every confidence that I would recover as I had before, although I was told I should give up running. I accepted that and I was just grateful that finally I would be pain free. However, my knee never got better and continued to be so painful that I could walk only with a marked limp.

In addition, for a while I had bad lumbar pain, especially in the morning. I thought I just needed a new mattress, but no matter how many mattresses I tried (I drove the mattress store employees crazy) my low back pain persisted. But it was not only lumbar pain—my whole body hurt and my toes were numb. I went to my internist, and after doing a cursory exam he concluded that I didn’t have any disc involvement and put me on an anti-inflammatory medication.

I asked him if I should at least get an MRI, but he rejected that idea due to the cost. I emphasized to him that my whole body ached, but nothing was ordered. I finally decided that I would “self-refer” to a neurosurgeon.

I went to Dr. B, an osteopath. He ordered a lumbar MRI and it revealed spinal stenosis, pretty common in someone my age.

We decided on a course of epidural steroid injections, which proved to be mildly successful for about a week.

Then after two courses of this treatment, the pain returned and he finally referred me to one of the neurosurgeons (Dr. S) in the same practice.

My surgery was scheduled for Election Day 2012 and I had high hopes of becoming pain free again. At that time I was a massage therapist, and it was very difficult to practice my occupation and bend over, trying to relieve others’ pain, when my back was killing me.

I went home from the hospital the next day with a plan to do lots of walking and get myself back on track for a quick recovery. However that was not the way it played out.

Within a week, I was having balance trouble and within two weeks I was reluctantly using a cane to get around. My right knee was just as painful as ever and I could not walk without a limp and a cane. I began to have nerve pain unlike any I had ever experienced before. I searched the Internet for some type of explanation and came up with “failed back surgery” as the culprit as I read story after story of patients who never recovered from lumbar surgery.

I just sat there, numb and disbelieving, my last hope dashed.

Now my 4 month long nightmare began in earnest.

I went back to the doctor and spoke with the surgeon’s very unsympathetic physician’s assistant who said, “give it time” and that the “nerve root needed to heal.” I tried to do just that, but instead of seeing improvement my symptoms became worse and worse.

At this point, I had severe burning and tingling nerve pain from my waist to my toes. I had a mysterious pressure on my abdomen and back whenever I stood, relieved only when I sat or lay down. My right leg was cold to the touch, beginning to atrophy, and I could not lift it properly, much less walk without a cane. What made this so nightmarish was that NOBODY BELIEVED ME. Each time I went in for a check up, I was told over and over, “Well, this is so unusual. We’ve never seen this before,” as if it must be psychosomatic in nature—that was the implication. In the meantime, I was so debilitated at this point that I had to keep crutches and a cane by my bed so I could get to the bathroom at night.

I actually drove, but with my heart in my mouth because my partially paralyzed right leg didn’t function properly. I had so many close calls that I knew God had to be traveling with me each time I ventured out.

I had to lift my leg up with my hands to get it in the car and my biggest fear was that I would kill a person or family while driving. When I went shopping I would try to park as close as I could to the store, sometimes abandoning my mission because it was too far to walk. Everything that we take for granted was an effort and it gave me a great

appreciation for what disabled people deal with on a regular basis. I asked the physician’s assistant if she could take pity on me and write a note for me to get a disabled car tag, but she refused stating, “Those are only given to people who are totally paralyzed” which is untrue. I ended up getting one from my orthopedist instead.

I went in for another lumbar MRI because they wanted to see if the surgical site gave them any clues. It didn’t.

I was suffering, both physically and psychologically and I began to lose hope.

But I soldiered on. Each day I would wake up with hope that maybe the nerve root was finally healing and maybe, just maybe, I could at least walk a little better. Some days I would fool myself into believing that there was a tiny bit of improvement and my mood would be bolstered. But that positive mood was dashed the next day when, upon waking, it became apparent that I was not any better, and in fact, probably worse.

We all know that hope is everything, and I had none. At this point I began to consider suicide every morning, even planning the method. I believe what kept me going is that I employed a 12 step program tool, thinking in terms of “one day at a time.”

I would think, “OK, whatever you want to do, you can put this off until tomorrow” and that kept me going in the world for another day. On days that I was so depressed, I would force myself to go to the gym, and although I didn’t go into the regular part of the gym because I was embarrassed by my debilitated state, I went to the disabled pool. It was there that I would find some solace because, although here I was with withered polio-like leg, ambling into the pool with the use of my cane, I saw people far worse than me—quadriplegics with happy expressions; wheelchairbound people. I said, “Thank you, God.” I continued going to the medical practice for checkups, only to be shuffled

back and forth to various departments. All the while, they were baffled by my deteriorated state. One day they decided to perform an EMG (electromyography) and I was so hopeful that finally they would find the reason for my crippling condition. On New Years Eve, 2012 I was in my car when I received a call from the nurse stating that the EMG showed nothing but an old radiculopathy.” In plain English—nothing new and nothing that would account for my deterioration. That day was significant in that I just sat there, totally numb and disbelieving, my last hope dashed, and thought that I could not bring myself to go on in the world. A friend of mine happened to see me, and asked if I was OK and suggested we go to Starbucks, which saved me for another day.

The next person to see me at that practice was the pain management doctor who gave me the news in an abrupt manner that he could not help me. He prescribed Lyrica and Neurontin for nerve pain, but all it did was cause me to fall because it made my muscles weak, so I stopped that immediately. I was so angry at his lack of empathy and bad bedside manner, but it turned out to be the best thing that happened because he referred me back to the original doctor, going full circle.

Dr. B, the osteopath, just sat and actually pondered what might be going on and what my options were. He treated me as a person and his kind, thoughtful manner was appreciated. The new plan was to embark on yet another course of epidural steroid injections, but suddenly a thought occurred to him—a thoracic MRI! We did that, and as soon as he pulled up the MRI on the screen, his eyes lit up because the MRI revealed a small benign tumor (meningioma) pressing on T3 of the spinal cord.

Boom—my world exploded in a good way. He excitedly said, “Here’s your problem.

This meningioma is pressing on T3, causing all your Please see DIAGNOSIS page 10

MARCH 3, 2017

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AUGUSTA MEDiCAL EXAMINER

Southern Girls Eat Clean Kung Pao Vegetables and Brown Rice Who loves Chinese food?

Here is a super nutritious version of the very popular Chinese dish, Kung Pao. Kung Pao Chicken was one of my favorite entrées a few years back. It was always my choice at the Chinese buffet. Yes, that sea of food where you go and graze over tons of deep fried dishes that are loaded with unhealthy fats and MSG (Monosodium Glutamate) To top that off, add a big ol’ helping of enriched white rice. Then you leave, stuffed to the gills and unable to breathe because you have eaten too much.

Been there? I have, many times.

This Kung Pao dish is a much healthier and nutritious meal. It has all the flavor of Kung Pao, but ramps up on nutrients by adding loads of veggies, cashews and brown rice. We had this meal last weekend and it reminded me again of how much I enjoy Chinese food. If you love Chinese food too, you don’t have to give it up. You do not have to sacrifice flavor just because you want to eat a healthy diet. By adding several levels of flavor to a recipe you can satisfy your Kung Pao Vegetables & Brown Rice palate and stick to a clean diet.

In a large, deep skillet, pieces Also, by replacing brown heat 1 Tbsp. of olive oil over • 1 organic red bell pepper, rice in recipes that call for medium-high heat. Add seeded and sliced white rice, you are doing your chopped caulifl ower and • 1 organic yellow bell pepper body a big favor. toss in oil.

Cook, stirring seeded and sliced Here are a few comparisons often until slightly softened • 1 cup of organic button of white and brown rice.... and browned, approx.

5mushrooms, sliced • Brown rice is a whole grain 8 minutes.

Remove the • 1-1/2 cups of organic sugar and is one of the healthiest cauliflower from the pan and snap peas, ends trimmed types of grain you can eat. set aside.

• 1 Tbsp. of fresh ginger, Whole grains are left in the Add the other tbsp. of minced their natural state and are olive oil to the skillet and • 2-3 cloves of fresh garlic, unrefined. reduce to medium heat. Add crushed • White rice has had the germ the peppers, mushrooms, • 5 scallions, chopped (white and the bran of the grain snap peas to the pan and and green parts) polished away, which takes cook, stirring often until • 1 tsp. of crushed red pepper away most of the nutritional slightly softened, approx. 5-8 fl akes (more or less to taste) value. minutes.

Do not overcook.

• 1/3 cup of raw cashews • Brown rice is full of Reduce heat to mediumFOR THE SAUCE: nutrients such as Selenium, low and add ginger, garlic • 2 Tbsp. of rice wine vinegar Magnesium and Manganese. and scallions to the pan. Toss • 2 Tbsp. of organic low sugar Percentage wise, much more with other veggies and cook tomato ketchup than white rice.

1-2 minutes.

• 4 Tbsp. of gluten free soy • White rice is low in fiber.

Place the cauliflower back sauce Brown rice is high in fiber. into the skillet and pour the • 1-2 Tbsp. of honey or • White rice has more of an sauce into the skillet over the organic cane sugar impact on blood sugar levels veggies.

• 1/4 cup of fi ltered water than brown rice.

Add the crushed red pepper • 3 tsp. of arrowroot powder • While white rice has less and cashews to the skillet (for thickening) fat than brown rice, the and simmer for 5-7 minutes fat content in white rice is until the sauce has thickened.

Instructions: primarily Omega-6 fatty Remove skillet from heat Cook brown rice according acids, which is considered and serve vegetables and to package directions in a rice pro-inflammatory, not the sauce immediately over cooker or on the stove top. beneficial anti-inflammatory. brown rice. + Wash and chop all of the If you love Chinese food as Alisa Rhinehart is half of the veggies: cauliflower, red I do, skip from the buffet and blog southerngirlseatclean. and yellow peppers, ginger, try this recipe. mushrooms, snap peas, garlic com. She is a working wife and mother living in Ingredients: and scallions.

Evans, Georgia.

• 4 cups of cooked brown rice In a small bowl, whisk Visit her blog for • 2 Tbsp. of extra virgin olive together rice wine vinegar, more recipes and oil ketchup, soy sauce, honey (or information on • 1 large organic cauliflower sugar), water and arrowroot clean eating. head - cut into small bite-size powder. Set sauce aside.

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Plus more than 875 doctors offices throughout the area for staff and waiting rooms, as well as many nurses stations and waiting rooms of area hospitals.

Very little if anything about healthcare is inexpensive, and that includes medicine. Tiny pills can command large prices. Over-the-counter medications may be less expensive, but are they also less effective? Find the answers to lots of your drug store questions in this column written

by Augusta pharmacists Chris and Lee Davidson exclusively for the Medical Examiner.

HEART FAILURE IN AMERICA In the last issue we discussed the implications and treatment of hypertension. In this issue we will look into another form of heart disease and that is heart failure. Heart failure is a huge problem in the United States, with one in nine death certificates listing heart failure as the cause of death. There are an estimated 5,750,000 million people in the U.S. with heart failure. Even though a heart failure diagnosis is associated with an increased risk of death and a poorer quality of life, outcomes have improved over the last few decades.

Between 1979 and 2000 there was a 9 percent increase in the five-year survival rate, so there is hope. Now let’s look at some of the causes of heart failure and then we will try to get into the possible treatments.

There are two main triggers of heart failure and that is to either restrict the filling of the ventricles or to decrease the contractility of the heart muscle. The first defect is called diastolic dysfunction, while the latter is called systolic dysfunction. There are many ways to cause one of these defects, which include the obvious: a past history of heart attack tops the list, which also includes ventricular enlargement due to pressure overload or volume overload. This is related to what the heart has to pump against on a daily basis. Diastolic dysfunction can be caused by valve problems or pericardial disease, which is a swelling of the membrane that envelopes the heart. Heart failure is a progressive disease, so even though you may survive the initial event, such as a myocardial infarction (heart attack), the damage will continue to get progressively worse over time. This is why regular follow-ups with a cardiologist is so important.

The main signs of heart failure — including shortness of breath, tiredness and fluid retention — can be mistaken for a number of conditions, so see your doctors right away and let them rule out as many causes as possible, then zero in on the ultimate diagnosis. The typical outward symptoms can limit your ability to exercise and stay active, but be warned: just taking it easy

and sitting around will only make things worse. Work out an exercise program with your doctor and stay as active as you can. Other signs and symptoms of heart failure are pulmonary fluid retention, rapid heart rate, jugular vein distension and cough. A person may also experience poor appetite and mental status changes. In addition to a full laboratory profile to help get a clear picture of your body’s status, a doctor checking for heart failure will also perform an electrocardiogram and a chest x-ray. As we said earlier, the recommendation is to stay active as allowed. This is also accompanied by dietary restrictions on both fluid and sodium.

There are four stages of heart failure and I will leave it to the doctors to explain the classification as it relates to you. Here we will focus on the medicines one can use to help treat heart failure and slow its progression. As we discussed in our hypertension chat last time, the medicines used to treat the blood pressure issues at work in heart failure can include ACE inhibitors and ARBs. These both work through the angiotensin system in the kidney. Beta-blockers are also used to prevent the symptoms of heart failure. There is a drug called digoxin that has been shown to reduce the number of hospitalizations and in certain situations your doctor may prescribe blood pressure medicines to help with your specific symptoms. There are also situations where blood thinners should be used to prevent complications. Diuretics are also a mainstay of treatment to reduce the volume overload present in a number of heart failure patients.

Expect a combination of medicines used to help keep you alive and well so that you can cope with your heart failure diagnosis. + Written for the Medical Examiner by Augusta pharmacists Chris and Lee Davidson Questions, comments and article suggestions can be sent by email to cjdlpdrph@bellsouth.net

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DON’T LICK THE BEATERS Useful food facts from dietetic interns with the Augusta Area Dietetic Internship Program, Augusta University

WHAT ABOUT THE PALEO DIET?

by Nicole Lee, Dietetic Intern

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AUGUSTA MEDiCAL EXAMINER

he Paleo Diet, also known as the Paleolithic Diet, Caveman Diet, or StoneAge Diet, has been gaining in popularity since the publication of The Paleo Diet by exercise-physiologist Loren Cordain in 2002. By 2013, the Paleo diet had risen to the most searchedfor diet term on Google. Its popularity is due in large part to exercise trends like CrossFit (an extreme fitness routine that mixes high intensity aerobics, calisthenics, and Olympic weightlifting), which advocates following a strict Paleo diet in order to achieve optimum physical results with their program.

The Paleo Diet gets its name from the fact that it is supposed to mimic an eating style similar to that of our Paleolithic ancestors. The diet is based mainly on foods that could be hunted and gathered (meat, fish, nuts, fruits, and vegetables) and avoids all

farmed foods (grains, dairy, and added sugar). Proponents of the diet claim that our digestive systems have not evolved as quickly as our food supply has changed, although there is no scientific proof to support this. They claim that when humans eat modern processed foods, their bodies do not yet know how to digest them and this causes inflammation (the body’s response to something foreign or harmful). Being exposed to high levels of inflammation over a long period of time has been shown to lead to diseases like Type 2 diabetes and cardiovascular disease. Again, there is no scientific proof that eating grains, dairy, or sugar in moderate amounts causes these chronic diseases.

There isn’t a large amount of research available to analyze this relatively new diet, but one large study that looked at four randomizedcontrol trials of the diet was

published in 2015. It showed significant improvement in waist circumference and total triglycerides, and moderate improvements in blood pressure, HDL cholesterol, and fasting blood glucose while on the diet. All the diets studied were similar in that they contained only unprocessed meat, fish, eggs, vegetables, fruit, and nuts, and provided approximately 30% of calories from protein, 40% from fat, and 30% from carbohydrates. In comparison, the control diets, which mimicked typical Western diets, provided only 10-20% of calories from protein and 25-30% from fat with a significantly larger percentage of calories coming from carbohydrates (45-60%).

In terms of the ability to adhere to the diet long-term, the Paleo diet can be costly, since a larger percentage of calories must come from protein, usually more expensive than carbohydrates.

The Paleo diet is also extremely restrictive in that it eliminates entire food groups (dairy, grains, beans, added sugar, alcohol, processed foods, etc). This makes eating out or buying prepared foods difficult if not nearly impossible, and so places a greater burden on individuals to plan and prepare meals from scratch. Although cooking at home can be much healthier than eating out, it is not realistic to avoid restaurants altogether.

The Paleo diet does have some good qualities, especially that it incorporates lots of fruits and vegetables.

Please see PALEO page 10

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PALEO… from page 9 One finding as to why the Paleo diet shows positive results is that when individuals do not eat grains, they automatically consume the recommended amounts of fruits and vegetables in order to feel full. Although this is beneficial, eliminating all grains, especially whole grains, can be deleterious to health.

Whole grains are one of the best sources of soluble fiber, which has been proven to lower LDL cholesterol. Foods with insoluble fiber, like vegetables, do not lower cholesterol as effectively.

Additionally, the Paleo diet tends to incorporate more protein, specifically animal protein, since plant sources, like beans, are not allowed on the diet. Animal protein tends to be higher in saturated fat, which is known to increase cholesterol levels. So, although the four studies showed moderate improvements in other cardiovascular markers, they did not show a decrease in LDL cholesterol, which is inline with the results from several decades of research on high saturated fat diets.

Another aspect to consider when looking at the Paleo Diet is that is completely excludes dairy, which is one of the richest sources of Calcium in the diet. There are some studies that show no change in calcium excretion in the urine of people who follow the diet. This typically indicates that calcium stores in the body are adequate, but no studies have looked at the longterm effects this diet may have on actual bone-mineral density.

An additional positive aspect of the diet is that it eliminates all processed foods. Processed foods are not optimal food choices since they are high in trans fats, sodium, and added sugar, so eliminating these foods, completely, can be beneficial to health.

Although the Paleo diet is commendable for encouraging individuals to consume more fruits and vegetables and eliminate processed foods, there is no reason to avoid whole grains and dairy. Each of the food groups provides specific, indispensible nutrients that must be consumed together in order to provide a well balanced, nutritionally sound diet. + Sources: • https://en.wikipedia.org/wiki/Paleolithic_diet • https://en.wikipedia.org/wiki/CrossFit • Manheimer, E. W., van Zuuren, E. J., Fedorowicz, Z., & Pijl, H. (2015).

Paleolithic nutrition for metabolic syndrome: systematic review and meta-analysis. The American journal of clinical nutrition, 102(4), 922932.

• Queenan, K. M., Stewart, M. L., Smith, K. N., Thomas, W., Fulcher, R. G., & Slavin, J. L. (2007). Concentrated oat -glucan, a fermentable fiber, lowers serum cholesterol in hypercholesterolemic adults in a randomized controlled trial. Nutrition Journal, 6(1), 1.

The Genuine. The Original.

Part L of a 26-part series

Keeping pipes clear Everyone within the sound of this newspaper knows that cholesterol levels are important.

But how many of us actually know our personal cholesterol numbers is no doubt another matter altogether.

What most of us know — or think we know — is that cholesterol is bad stuff, the smoking gun in many cases of heart and vascular disease.

That, as it turns out, is a misleading half-truth. Cholesterol is an essential component of all cells, required to build and maintain cell membranes. It also enables intracellular transport, cell signaling and nerve conduction. Every cell is capable of synthesizing it through a complex 37-step process, and the body synthesizes about 1,000 mg per day to go along with the average dietary intake of around 300 mg in the US.

IS FOR LDL The problem with this essential human ingredient comes when there is too much of it. Some people naturally produce too much cholesterol; some people have too much cholesterol in their diets; and still others face the dual threat of both.

Like everything in the body, cholesterol, a lipoprotein, is complex. “Total cholesterol” is comprised of two types:

high-density (HDL) and lowdensity (LDL) components called lipoproteins. HDL (“good” cholesterol) absorbs cholesterol and carries it back to the liver, which flushes it from the body. LDL is called bad cholesterol because too much of it contributes to heart disease and stroke. Unfortunately, LDL makes up the majority of the body’s cholesterol.

A desirable total cholesterol reading is below 200 mg/dL; 200-240 spells borderline high risk, while anything above 240 is considered high risk, but an individual’s HDL/LDL ratio — how much of each type is present — is also important.

Everyone should have their cholesterol checked at least every 5 years, and many need checking far more often. A 12hour fast before testing makes for the most accurate results. +

DIAGNOSIS… from page 6 symptoms.” It was as if God himself came down from the heavens and blessed me—I was so ecstatic that words cannot describe it. I am brought to tears when I think of that moment. He quickly referred me back to the original surgeon, Dr. S, who was shocked and humbled. I actually did not want to use the same surgeon, but I realized she knew my case and I could get this done very soon.

Just prior to surgery I discovered an article from a Japanese case study that said, “If a patient is not recovering from lumbar surgery, the surgeon should consider the possibility of a thoracic meningioma.” I sure wish I had seen that article months before, but at least it was finally correctly diagnosed. The spinal surgery, scheduled for a week later, was rough but successful. Right out of the recovery room, I clearly remember lifting my right leg, unaided, and being elated. After a hard 5 days in the hospital, in severe pain, I was released. A home care nurse was ordered for 2 weeks but I only needed her for a week. My walker went into the garage along with my cane and crutches.

I am athletic and I began to recover so quickly due to my previous good shape and

I began going to the gym again. I had to be careful that nobody slapped me on my back for a while, which would send me to the moon but other than that, it was fine. My damaged knee began to heal, and my atrophied and cold right leg began to warm and plump out, looking normal again.

I was bitter at first for all the doctors who I felt failed me, starting initially with my internist and I even considered hiring a lawyer to sue. But I then began to think about gratitude and forgiveness and by the grace of God, a solution to my suffering was found. I began to think that maybe my travails helped me be more empathetic to the disabled, an experience I never would have had otherwise.

March 1 marks four years since I got my life back. Each time I perform an otherwise unremarkable feat such as walking briskly across the room, or climbing stairs unaided, I am still in awe. Sometimes I am merely in Walmart and I marvel at how fast I can walk, or in an airport, briskly passing people on the way to my connection.

It is amazing and miraculous and I will never stop being grateful. +

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The blog spot From the Bookshelf — posted by Helena Frischtak on February 26, 2017

OBESE PATIENTS AND OVERT DISCRIMINATION It was around 2 p.m. when a 380-pound woman came into the ER. She was in her late 30s. The physician went to see her and then ordered IV fluids, some basic blood tests, and a urine sample.

At a hospital, everyone’s job is made harder when a patient is obese. Getting the patient on the bed requires more personnel. Inserting an IV — an intravenous catheter to infuse fluids or medications — takes more time. A physical exam is more difficult and invariably less precise: heartbeats and breath sounds are muffled by the layers of fat; palpating abdominal organs is practically impossible.

When the nurse went into the patient’s room to draw labs, she couldn’t get an intravenous line in. She called a fellow nurse, who tried a few times. She, too, failed. Thus, the doctor was called to put in a femoral line. When arms and hands fail, we go to the top of the leg, in the crease next to the groin.

I felt the physician’s impatience as he strode towards the room: Patients shouldn’t be fat enough that they bury all their arm and hand veins. Starting an IV shouldn’t be his job.

He worked swiftly, arranging the materials he needed while positioning the patient on the bed. This woman was so large she required two nurses to hold her abdominal fat away while the physician palpated her left groin.

It is an unspoken rule in medicine that patients should always be covered in areas that don’t require exposure, but no one tried too hard with this lady. The patient did not have time to consider her modesty, nor time or opportunity to protect it. Her lower body was fully exposed to the four people in the room.

As the nurses pulled up her abdominal fat, a stench permeated the room. If it is not a familiar stench, it is certainly a recognizable one: that of skin folds that have been in contact with each other for a long time, without much exposure to air. It is the odor of bacteria and fungi having a party on your skin.

As the doctor pushed on her groin with his hand to locate her femoral vein, she moaned in pain, contorting her whole body and making his job more difficult: “That hurts! It hurts!” To us, she seemed to be acting like a child. Despite the groin being a sensitive area, he was just pressing on her. On the other hand, pain can be anticipatory, and things were happening fast. No one was walking her through what we were doing, or giving her any time to process it.

I have noticed time and again that when adults experience pain like children, they garner very little sympathy from doctors. In our patient’s case, it wasn’t only her behavior that was hard to relate to — it was also, as hard as it is to admit, her size. That’s the thing about being over 350 pounds: One does not get to feel pain or be sensitive and tender like skinny people do and are. It is as if one lost that privilege, in part because he or she is so big there’s nothing perceptibly delicate about them, and in part because a doctor physically can’t get anywhere unless he or she palpates and presses hard on the patient. After all, the organs are buried deep inside.

Finally, the doctor located the pulsating femoral artery, next to which lay the vein. He stuck her with a big needle, and dark blood rushed out while the patient screeched

I could feel the doctor’s impatience

Please see BLOG SPOT page 14

This is a book that comes with an accurate description of its contents, right there on the cover. Forensic science, it says, is often gruesome but always fascinating.

We agree here at the Medical Examiner’s palatial world headquarters in Augusta, Georgia, and the rest of the nation (if not the world) seems to agree.

After all, the number of CSI-type shows on television is practically without counting. There are even entire networks, like ID (Investigation Discovery) that are devoted to crime and punishment 24/7/365 (not counting commercials).

As you might surmise if you are a bit of a detective, having an author whose name is Nigel indicates the book might have a bit of a British slant. True, not that that’s a bad thing. Actually, pretty much the whole world of forensics is examined in all its fascinating detail in this book, including Britain, France, and even right here in the US of A. Nigel McCrery takes us to the scene whenever and wherever there

was a fascinating case or a breakthrough in forensic methods.

He breaks it down into a handful of categories, areas like ballistics, blood, trace evidence, poisons, DNA, and so on.

Looking back on the history of the science and its present state, it’s a wonder they managed to catch and convict the right perp even half the time back in the day.

And it’s equally amazing that anybody gets away with anything these days with the

forensic tools available today.

The sad truth when it comes to forensic science is that the cost of each and every advancement was paid over the centuries with rivers of shed blood and untold lives cut short by acts of violence and mayhem. Blood spatter experts, for instance, hone their craft when blood is spattered and splattered.

Like the subtitle says, it’s often gruesome.

But thankfully, people have been willing to work in and gradually refi ne, expand and improve the art and craft of forensic science to the point where, today, it provides the basis for many, many TV shows.

Plus it helps solve (and no doubt prevent) countless crimes. If the often gruesome but always fascinating history of forensic science appeals to you, this is a book you’ll definitely enjoy. +

Silent Witness: The Often Gruesome but Always Fascinating History of Forensic Science by Nigel McCrery; 288 pages, published in September 2014 by Chicago Review Press

Research News Big type 2 news London’s Imperial College has big news for type 2 diabetics: a repurposed weight loss drug has been shown to significantly cut the risk of type 2 diabetes.

The drug, liraglutide, was administered to half of the more than 2,250 obese adults in the study with “prediabetes,” or “borderline diabetes,” a state which often leads to type 2 diabetes when untreated. Significantly, prediabetes is curable or preventable with exercise and dietary changes, but the situation isn’t the same once the disease progresses into diabetes.

After three years, compared to the control group taking a placebo, the liraglutide takers were found to be 80 percent less likely to develop diabetes, and in 60 percent of those participants, prediabetes was reversed and their blood sugar readings returned to healthy levels.

Gum and candy news New York researchers at Binghamton University, SUNY, say that the ability of the small intestine to absorb nutrients and act as a barrier to pathogens is “significantly decreased” after chronic exposure to titanium dioxide, a common food additive.

One of the study’s authors was quoted as saying, “Titanium dioxide is a common food additive and people have been eating a lot of it for a long time — don’t worry, it won’t kill you — but we were interested in some of [its] subtle effects, and we think people should know about them.”

The FDA recognizes titanium dioxide as safe; it would be practically impossible to avoid eating it, and exposure generally amounts to, at most, nanoparticles. Although the chemical appears in products ranging from sunscreens and paint to bread and chocolate,

researchers say that chewing gum and candy are among the top sources — and theoretically the most easily avoidable.

It’s smart to take your meds After a heart attack, patients almost always get prescriptions for statins, drugs which are key for secondary prevention and cholesterol reduction.

Not taking the medicines raises the risk of another heart attack and death. Even so, many people do just that: stop taking their meds.

Why? Previous studies have identified factors linked to everything from the drugs’ side effects to socioeconomic status.

Now a new 30-year Swedish study has identified general cognitive ability — in a word, intelligence — as an additional factor.

Simply put, smart people take their medications. +

+ 12

MARCH 3, 2017

AUGUSTA MEDiCAL EXAMINER

THE EXAMiNERS +

by Dan Pearson

It’s been getting The whole social You look annoyed. media thing is totally You’re just noticing? worse every day for Well, today I actually Have you been in a coma What’s wrong? out of control.

And it’s getting 5 years. Why now? had a bird tweet me. somewhere? worse every day. © 2017 Daniel Pearson All rights reserved.

EXAMINER CROSSWORD

PUZZLE ACROSS 1. Sleep disorder 6. 1975 blockbuster 10. Fed. med. agency 13. Unambiguous 14. Hawaiian island 15. Bar intro?

16. A movie star is often one 18. _____ glass 19. Consume 20. Temple 21. Rugged 23. Shirts and blouses 24. Hot ______ 25. ______-Sinai 28. Furthest back 31. Music hall 32. Tantalize 33. Name for 13 popes 34. R. A. ______ Blvd.

35. Clean and treat a wound 36. Attired 37. Ostrich-like bird 38. What flooding rivers do 39. Plants 40. Yellow, crystalline dye 42. Half asleep 43. Thorax, in plain English 44. If you don’t care at all, you don’t give one of these 45. Willows 47. French city on the English Channel 48. Type of mask 51. Wound reminder 52. The act of enrolling 55. Type of bloomer 56. Underwater ridge 57. It leaves the left ventricle 58. Metal-bearing mineral 59. Couch 60. Downtown building

BY

The Mystery Word for this issue: COSERBIA

Simply unscramble the letters, then begin exploring our ads. When you find the correctly spelled word hidden in one of our ads — enter at AugustaRx.com All Mystery Word finders will be eligible to win by random drawing.

We’ll announce the winner in our next issue!

VISIT WWW.AUGUSTARX.COM 1

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Click on “READER CONTESTS”

QUOTATION PUZZLE

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E R D W A U E O I I E E F S O L P V E D C O N O S O Y H O S S S W P U H R D E W S N U R W

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— Annie Dillard

by Daniel R. Pearson © 2017 All rights reserved

by Daniel R. Pearson © 2017 All rights reserved. Built in part with software from www.crauswords.com

DOWN 1. Continuous dull pain 2. Court proceeding 3. Tidy 4. Type of ring 5. Poetry or sculpture, etc.

6. Augusta-born artist Jasper 7. River in central Switzerland 8. Global health org.

9. Secondary category 10. Broad Street restaurant 11. Mr. Barnard 12. Askew 15. Abyss 17. Evening song?

22. Like some steaks 23. Stretched tight 24. Famine’s ironic partner 25. Ancient manuscript in book form 26. Swelling 27. Denounce 28. AU’s Summerville Library 29. Common mall anchor

30. USA _________ 32. The ___ Affair, a diplomatic incident between the US and Britain during the Civil War 35. Items of bedroom furniture 36. It often follows blood 38. She was once married to Gregg Allman 39. ____ assault 41. Monetary unit of Botswana 42. Female deer 44. Seaport in NW Israel 45. Capital of Norway 46. Disfigure 47. Musical symbol 48. Bug 49. First 4 letters of the south polar region 50. The state flags of California and North Carolina each have one 53. Nazi beginning?

54. Emu-like exticnct bird Solution p. 14

DIRECTIONS: Recreate a timeless nugget of wisdom by using the letters in each vertical column to fill the boxes above them. Once any letter is used, cross it out in the lower half of the puzzle. Letters may be used only once.

Black squares indicate spaces between words, and words may extend onto a second line.

Solution on page 14.

E

X A M I N E R

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by Daniel R. Pearson © 2017 All rights reserved. Built with software from www.crauswords.com

U D O K U

DIRECTIONS: Every line, vertical and horizontal, and all nine 9-square boxes must each contain the numbers 1 though 9. Solution on page 14.

Use the letters provided at bottom to create words to solve the puzzle above. All the listed letters following #1 are the first letters of the various words; the letters following #2 are the second letters of each word, and so on. Try solving words with letter clues or numbers with minimal choices listed. A sample is shown. Solution on page 14.

1 2

I 1 2 3 4 5 6

1 2 3 4 5 6 7 8 9

1 2

M 1 2 3 4

1 2 3 4

1

O 1 2 3 4 5 6 L 2 1 2 3 4 5 6

— Lord Chesterfield

1.AIAFITSIM 2.SHOONNNNU 3.CRSJOA 4.GHUUNN 5.ROLE 6.RTTY 7.T 8.E 9.N

SAMPLE:

1. ILB 2. SLO 3. VI 4. NE 5. D =

L 1

O 2

V 3

E 4

I 1

S 2

B 1

L 2

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by Daniel R. Pearson © 2017 All rights reserved

WORDS NUMBER

THE MYSTERY WORD

MARCH 3, 2017

AUGUSTA MEDiCAL EXAMINER

13 +

THE BEST MEDICINE ha... ha...

“Jesus, Mary and Joseph! Ye scared me half to death, girl! I thought ye said a Protestant.

Come here and give yer old man a hug.”

Moe: What does DNA stand for?

Joe: National Dyslexic Association.

Moe: Thanks.

A

n Irish girl had been away from home for more than five years without a word.

Upon her return, her father angrily asked, “Where have ye been all this time, girl? Could ye not write to us, not even a line? Why didn’t ye call? Can ye not understand what ye put yer old mum through?”

Through tears the young woman replied, “Dad... I’m so sorry... I became a prostitute.”

“Ye what!!? Get out of here, ye shameless sinner! You’re a disgrace to this family.”

“I understand me father,” she sniffed. “As ye wish. I just came back to give mum this luxurious fur coat, the deed to a ten-bedroom mansion plus a savings certificate for $1 million.”

“For me little brother, this gold Rolex,” she went on. “And for you daddy, the new Mercedes convertible that’s parked outside, plus a membership to the country club. And — I want you all to spend New Years’ Eve on board my yacht in the French Riviera.”

“Now what was it ye said ye had become?” asks dad.

The girl, still crying, said, “A prostitute, daddy!”

Moe: Where were you born?

Joe: In Canada.

Moe: What part?

Joe: Uh, pretty much my whole body.

Moe: Where do babies come from?

Joe: Well, the little ones are delivered by stork.

Moe: And the big ones?

Joe: For those you need a crane.

A man went to see his doctor and got terrible news.

“I’m afraid I have bad news for you,” the doctor said. “I estimate you have only six months to live.”

The man just couldn’t accept that, so he beat up the doctor with a baseball bat, and a judge gave him ten years.

A Russian mafia tough guy retires and decides to go into watch and clock repairing.

His fi rst customer brings in a clock and says, “Something is wrong with my clock. It used to go tick-tock, tick-tock, but now it only goes tick...tick...tick...tick...”

“No problem,” says the watchmaker, taking the clock from its owner. He shines a light in the clock’s face and says menacingly, “We have ways to make it tock.” +

Why subscribe to the Medical Examiner?

Because no one should have to make a trip to the doctor or the hospital just to read Augusta’s Most Salubrious Newspaper.

+ +

SUBSCRIBE TO THE MEDICAL EXAMINER By popular demand we’re making at-cost subscriptions available for the convenience of our readers.

If you live beyond the Aiken-Augusta area or miss issues between doctor’s appointments — don’t you hate it when that happens? — we’ll command your mail carrier to bring every issue to your house!

NAME ADDRESS CITY

STATE

ZIP

Choose ____ six months for $20; or ____ one year for $36. Mail this completed form with payment to Augusta Medical Examiner, PO Box 397, Augusta GA 30903-0397

ON THE ROAD TO BETTER HEALTH A PATIENT’S PERSPECTIVE Editor’s note: Augusta writer Marcia Ribble wrote a long-time column in this paper entitled The Patient’s Perspective reincarnated in this new format. Feel free to contact her at marciaribble@hotmail.com We may sometimes think of our health as something that occurs inside a bubble in which we and our health professionals work, mostly without input from outside the bubble — a view that is seldom the entire reality. We receive many helpful and unhelpful comments from people outside that bubble whose responses can be crucial to maintaining good health.

For example, as a long time diabetic, I have years of negative responses to my diabetes to overcome in order to deal with my disease successfully.

When I was fi rst diagnosed with diabetes, the natural assumption would have been that my family, anxious to secure my good health, would fully support my efforts to comply with diet and other necessary modifications to enable me to remain healthy. Many families do this, helping the patient follow the doctor’s best advice. Mine wasn’t one of those families. I’m not sure why, but they saw my diabetes as a personal affront to them, one they would rather didn’t exist.

I would walk into my mother’s home and she would invite me to have some freshly baked chocolate chip cookies, acting offended if I didn’t take some and eat them. When I tried to fi x healthy meals, my husband would reject them and talk about how disgusting they were. He might then insist that we have pizza or some other high carb meal. Naturally, we had five pizzaloving children to affi rm that choice, and to behave as though I was a liability if I protested. A few minutes with a doctor cannot erase days and nights of negative conditioning from the people who are supposed to love us, but who do not behave in loving ways.

The doctor isn’t there when a family member insists on stopping for milkshakes, or brings home our favorite dessert.

While we may start out strong and resolved to resist, over time our resistance to negative feedback can diminish to the point of non-existence. To avoid causing family turmoil, we sometimes cave-in to the demands of our non-diabetic family members to eat the kinds of food they like, even if those foods are not good for us. “Oh, a few chocolate chip cookies can’t possibly hurt you!

Don’t you want to celebrate so-and-so’s birthday with cake and ice cream? Don’t be a party-pooper, have some of this delicious wine! Why do you have to be so darned picky when you come over for family events?”

And it’s not just diabetics who sometimes have to endure this kind of anti-helpful pressure. People who are on low- or no-salt diets can get the same kind of treatment. Often the only food available to us in those circumstances has been heavily salted and is sure to affect our health badly. My dad had heart failure and was supposed to be on a low-no salt diet. My mother continued to heavily salt their food anyway, then griped about how “heavy” he was getting.

When we find ourselves in that kind of situation, outside help can be a life-saver. For me, overcoming years with a nonsupportive family has taken intensive support from my medical teams, from family members who are supportive, from friends on the web, from people who care.

If you are dealing with this, don’t give up. Find your own support system and learn how to take care of yourself. The fi rst step is to tell your doctor, “I’m non-compliant because.....” +

READ THE EXAMINER ONLINE www.issuu.com/medicalexaminer

+ 14

MARCH 3, 2017

AUGUSTA MEDiCAL EXAMINER

THE MYSTERY SOLVED The Mystery Word in our last issue was: ALLERGY

...very cleverly hidden (on the girl’s sleeve) in the p. 2 ad for THE JBWHITES BUILDING THE WINNER: JENNIFER YOUNG! Want to find your name here next issue? If it is, we’ll send you some cool swag from our goodie bag. The new Mystery Word is on page 12. Start looking!

The Celebrated MYSTERY WORD CONTEST ...wherein we hide (with fiendish cleverness) a simple word. All you have to do is unscramble the word (found on page 12), then find it concealed within one of our ads. Click in to the contest link at www.AugustaRx.com and enter. If we pick you in our random drawing of correct entries, you’ll score our goodie package!

SEVEN SIMPLE RULES: 1. Unscramble and find the designated word hidden within one of the ads in this issue. 2. Visit the Reader Contests page at www.AugustaRx.com. 3. Tell us what you found and where you found it. 4. If you’re right and you’re the one we pick at random, you win. (Winners within the past six months are ineligible.) 5. Prizes awarded to winners may vary from issue to issue. 6. A photo ID may be required to claim some prizes. 7. Other entrants may win a lesser prize at the sole discretion of the publisher.

BLOG SPOT… from page 11 in pain. He passed the line to the nurse, and walked out of the room without too many words.

Every patient is, by definition, vulnerable; their life is in the hands of a white coat, who is often a complete stranger. White coats vary in competence; and white coats are people, with moods and preferences and prejudices and good and bad days. There is also an inherent asymmetry of information and thus of power between patient and doctor. The very ritual of getting into a gown in the hospital robs the patient of dignity and identity, scrubs away their individuality, and contributes to this asymmetry.

This patient was vulnerable on a deeper level. She owned a body that is, to many, shameful. She is not alone: over one-third of adults in the U.S. are obese, and 6.3 percent are considered morbidly obese. Being obese usually doesn’t conjure up thoughts of pity or empathy. On the contrary, society blames her, and others like her, for looking the way they do. Maybe it is their fault that they are fat. Or

The new scrambled Mystery Word is found on page 12

SENDING US A CLASSIFIED? USE THE FORM BELOW AND MAIL IT IN, OR GO TO WWW.AUGUSTARX.COM AND PLACE & PAY CONVENIENTLY AND SAFELY ONLINE. THANKS!

Augusta Medical Examiner Classifieds

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AD COPY (one word per line; phone numbers MUST include the area code): .25

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The Augusta Medical Examiner publishes on the 1st and 3rd Friday of every month.

Your ad should reach us no later than 7 days prior to our publication date.

maybe they have an underlying metabolic or psychiatric disorder and their weight is out of their control.

But maybe it just doesn’t matter. Whatever the reason the patient is the way she is, perhaps we should instead recognize these patients for what they are — among the most vulnerable of all. Sure, we felt frustrated by the extra work our patient’s body habitus put us through. But it was not her choice to be in that room with layers of fat lifted by a stranger, causing that smell to emanate from her skin. She didn’t put that on us — we put that on her. If having witnesses to your body’s foul odors isn’t uncomfortable, then what is?

In the ED, we only interact with each patient for a short time, and it’s natural to fall into a pattern — quick to diagnose, quick to treat, but also quick to judge. The latter is not, it turns out, part of our role as physicians.

Sometimes, though, avoiding it is one of our hardest challenges. + Helena Frischtak is a medical student.

NEVER MISS AN ISSUU!

Visit us at issuu.com/medicalexaminer EXAMINER CLASSIFIEDS HOMES, APARTMENTS, ROOMMATES, LAND, ETC. FOR RENT 2000+ sqft warehouse space w/ loading dock, Walton Way Medical District. Available immed. $850.00/mo. incl. utilities. 706-564-1644 ROOM FOR RENT with private bathroom and full house privileges. Martinez $600/mo (706) 840-6860 FOR SALE 3 bedroom/2 bath, single garage Townhouse in Martinez. Master/ bath down, 2 upstairs bedrooms share bath, large loft for office, playroom, den; wood-burning fireplace, covered back porch. Freshly painted with new flooring, lighting and ceiling fans. Easy access to Riverwatch Parkway, Washington Rd, I-20, Augusta. 1987 sq.ft. $147,900.

706-836-7001.

ROOM FOR RENT 1 room, private bathroom, 2bdrm MH on private lot. Clean quiet neighborhood. Non-smoker. $600 monthly. Must be stable, verifiable references and income. Cable and Internet included. Warrenville, 5 min from Aiken, 20 min to Augusta. (803) 270-2658 POND VIEW! Evans all-brick 2-story with solar panels. Avg. electric bill $170 in Northwood, 3,400 sqft. Call 1-800401-0257, ext. 0043 24/7 for price and details.

SERVICES PETS Dogs walked, cats sat, in the comfort of your home by retired pharmacist.

No kennel noise, fleas, disease, transport cost/time. Avail 7 days/wk in Martinez/ Evans. $15 per visit. References. Call for free interview at your home. Call Buddy for your buddy: (706) 829-1729

HOUSE CLEANING Your house, apartment, rental move-outs. Thorough, dependable. Weekly, or whatever schedule you prefer. References. 706-877-0421 F. E. GILLIARD, MD FAMILY MEDICINE Acute & Chronic Illnesses Occupational Medicine PROMPT APPOINTMENTS (706) 760-7607

MISCELLANEOUS STARTING OUT? KICKED OUT? Refrigerator, stove and dryer, $490. Call 706-231-1653 SUNSET MEMORIAL GARDENS Opening and closing at Sunset Mem. Gardens in Graniteville. Sale: $760 (Value: $1520+) Call 706-736-0596 ANTIQUE maple dinette set with buffet corner cabinet table with pull-out leaves.

Four chairs with two captain’s chairs.

Excellent condition. $300. Double bed early 1930s with mattress spring coverlet shams $150. Call (706) 860-2170 CEMETERY SPACES (2) Sunset Memorial Gardens, Graniteville SC adjacent to lighted military flagstaff, includes granite bench with urn space, installation and inscription. All $4700 ($8600 value).

Spaces only: $2700. Call (803) 2953033 FISHING CLUB wants more grey-haired members. Meet 2nd Thurs of month at Harbor Inn Restaurant, 12 noon.

“Adventure Before Dementia” Info: (706) 736-8753

Please support our advertisers!

THE PUZZLE SOLVED A

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SEE PAGE 12

QUOTATION QUOTATION PUZZLE SOLUTION: Page 12: “How we spend our days is, of course, how we spend our lives.”

— Annie Dillard

The Sudoku Solution 7

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WORDS BY NUMBER “An injury is much sooner forgotten than an insult.”

— Lord Chesterfield

MARCH 3, 2017 Q: How do we tempt the taste buds?

IT’S A QUESTION OF CARE When elderly parents won’t eat properly — or at all

15 +

AUGUSTA MEDiCAL EXAMINER

Often, as we are concerned about an elderly loved one, we notice that they are not eating as frequently or in the same quantity as they have in the past.

Some of this behavior is part of the aging process: As our metabolism slows down and our taste buds become less sensitive, our appetite is often affected.

Even with those roadblocks, if you find that your elderly loved one will eat fairly well when he or she is with you, it can be a clue as to how to get them to eat more when you two are not together.

• Ensure they have foods in their home that they like and can easily prepare on their own. You or caregiver

can take them to the store to choose foods. Oversee the process to make sure they’re choosing decently healthy foods as well as selecting a combination of foods that they enjoy. You can also help monitor whether they’ve chosen items that will create a tasteful meal(s) that are simple to prepare.

• Cook with them or for them, or hire someone to do the same. It might be that you make a little extra two or three evenings a week and take it to them. You can also hire someone to cook with or for them in their own kitchen (if they will agree to this).

They can make a little extra and there are leftovers for the next meal.

• Eat with them or ask a caregiver to eat with them, as we all like company

when we eat. A meal tends to last longer when we have company, so your loved one might eat more if they have someone sitting with them to add to the conversation and the camaraderie.

• Introduce different foods to see if they might be open to new tastes. Particularly, introduce items that have a slightly stronger flavor, because as mentioned earlier, their taste buds aren’t as discriminating as in their younger years.

• Appeal to their sweet tooth. Since most older people tend to like sweets, offering sweets in moderation— though not the best for their health — can be an enticing part of their meal. Of course, once we get into our much later years of age, the saying tends to be: Eat whatever you

want, you deserve it!! There is some truth to this and may be part of the ticket to helping your loved one consume more calories. + For the last decade, Amy Hane has been committed to serving the CSRA community by guiding those going through mental, physical and social issues related to caring for an aging or disabled loved one. She assists families with transitions to higher quality care for the safety and wellbeing of all involved.

Amy holds both Bachelor’s and Master’s degrees from the University of South Carolina, is a licensed Master Social Worker in South Carolina and Georgia, an Advanced Professional Aging Life Care Manager and also a Certified Advanced Social Work Case Manager.

+

PROFESSIONAL DIRECTORY ALLERGY

Tesneem K. Chaudhary, MD Allergy & Asthma Center 3685 Wheeler Road, Suite 101 Augusta 30909 706-868-8555

CHIROPRACTIC Evans Chiropractic Health Center Dr. William M. Rice 108 SRP Drive, Suite A 706-860-4001 www.evanschiro.net

COUNSELING Resolution Counseling Professionals 3633 Wheeler Rd, Suite 365 Augusta 30909 706-432-6866 www.visitrcp.com

DENTISTRY

DERMATOLOGY

Georgia Dermatology & Skin Cancer Center 2283 Wrightsboro Rd. (at Johns Road) Augusta 30904 706-733-3373 www.GaDerm.com

DEVELOPMENTAL PEDIATRICS Karen L. Carter, MD 1303 D’Antignac St, Suite 2100 Augusta 30901 706-396-0600 www.augustadevelopmentalspecialists.com

DRUG REHAB Steppingstones to Recovery 2610 Commons Blvd.

Augusta 30909 706-733-1935

FAMILY MEDICINE

F. E. Gilliard MD, Family Medicine 4244 Washington Road Evans, GA 30809 706-760-7607 Industrial Medicine • Prompt appts.

Urgent MD Augusta: 706-922-6300 Grovetown: 706-434-3500 Thomson: 706-595-7825 Primary Care Rates

OPHTHALMOLOGY Roger M. Smith, M.D. 820 St. Sebastian Way Suite 5-A Augusta 30901 706-724-3339

PHARMACY

YOUR LISTING HERE

SENIOR LIVING

Augusta Gardens Senior Living Community 3725 Wheeler Road Augusta 30909 SENIOR LIVING COMMUNITY 706-868-6500 www.augustagardenscommunity.com

SLEEP MEDICINE Sleep Institute of Augusta Bashir Chaudhary, MD 3685 Wheeler Rd, Suite 101 Augusta 30909 706-868-8555

TRANSPORTATION Caring Man in a Van Wheelchair-Stretcher Transports • Serving Augusta Metro 855-342-1566 www.CaringManinaVan.com

VEIN CARE

Medical Center West Pharmacy 465 North Belair Road Evans 30809 Vein Specialists of Augusta Dr. Judson S. Hickey Your Practice 706-854-2424 Periodontist And up to four additional lines of your www.medicalcenterwestpharmacy.com G. Lionel Zumbro, Jr., MD, FACS, RVT, RPVI 501 Blackburn Dr, Martinez 30907 2315-B Central Ave choosing and, if desired, your logo.

Floss ‘em 706-854-8340 Augusta 30904 or lose ‘em! Keep your contact information in Parks Pharmacy www.VeinsAugusta.com 706-739-0071 this convenient place seen by tens of 437 Georgia Ave. thousands of patients every month. N. Augusta 29841 Jason H. Lee, DMD Literally! Call (706) 860-5455 for all 803-279-7450 116 Davis Road the details www.parkspharmacy.com Augusta 30907 Medical Weight & Wellness 706-860-4048 Specialists of Augusta THE AUGUSTA Maycie Elchoufi, MD MEDICAL EXAMINER Steven L. Wilson, DMD 108 SRP Drive, Suite B Psych Consultants Family Dentistry Evans 30809 • 706-829-9906 AUGUSTA’S 2820 Hillcreek Dr 4059 Columbia Road MOST SALUBRIOUS YourWeightLossDoctor.com Augusta 30909 Martinez 30907 NEWSPAPER (706) 410-1202 706-863-9445 www.psych-consultants.com

WEIGHT LOSS

I+

M.E.

PSYCHIATRY

+ 16

AUGUSTA MEDiCAL EXAMINER

MARCH 3, 2017